• Fort Lauderdale Wellness

What To Do When ADHD Stimulant Medication Fails?


The first step to treat ADHD is by taking medications, but what to do when ADHD stimulant medication fails? Or the ADHD symptoms worsen? Or the child witness medication side effects such as weight loss, insomnia, and irritability?


It is a disappointing reality that 20-40% of children do not respond to ADHD medications or show no or little improvement in symptoms. But parents need to understand that the purpose of the ADHD stimulant medication is to open the door to effective educational and behavioral therapy. Therefore, it is crucial to find the reason and failure and fix it.


1. The Medication: The two common stimulant medications amphetamine (Adderall) and methylphenidate (Ritalin) are the first line of treatment for kids with ADHD. If these drugs don’t give the desired results, other drugs should be tried to boost the concentration and ability to focus. While in some cases, the incorrect dosage can be the reason of ADHD stimulant medication failure. If the medication doesn’t work, you should adjust the dose either up or down. But before adjusting the dosage, it is best to wait for at least two weeks. The goal of the stimulant medication is to achieve a consistent and reliable response to the everyday circumstances. The decision for change in medication must be made carefully as it can be life altering for both the child and family. Success largely depends on monitoring the administration, dealing with the co-existing conditions, managing side effects, and understanding the child’s circumstances.


2. Wrong diagnosis: At times, the child doesn’t respond to two or three stimulant medications. It might be because of the incorrect ADHD diagnosis. Specific criteria need to be met before an attention deficit disorder diagnosis is made. In such cases, pediatricians need to re-evaluate the diagnosis of the child and test them for the co-existing conditions like the behavioral problem, bipolar disorder, depression, and learning disability.


3. Parent and teacher monitoring the drug therapy: The family and physician work in close association with each other to watch the reaction of the medication. The parents need to fill a questionnaire or form before the medication is started and redo it after a week of the treatment. It will help in assessing the improvement in the children and behavior and the unwanted side effects. Also, the teacher and the parent should often communicate so that the medication adjustments to deal with the side effects can be quickly made over the phone. This communication is essential to ensure behavior improvement.


As most parents discontinue the medication in the first two or three weeks because of the side effects or lack of response, the truth is that ADHD treatment will not be successful without these medications and reliable information from the parents, teachers, and child. Besides, behavioral therapy can help in managing the ADHD symptoms and lessen its impact on the child. The CBT targets the behavioral aspect and the thought processes that add to the kids' problem.


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